With self-compression, women suffer less and the quality of the mammogram is not at all

(Reuters Health) – There are many reasons why women do not like mammograms, including the delicate and often painful process of being crushed by a technician in a machine that flattens them for pictures.

But a trial in France suggests that bad cancer screening could be just as effective and less unpleasant when women can control the compression device themselves.

"Our study did not report any decrease in image quality during self-compression," said Dr. Philippe Henrot, lead author of the study, of the Lorraine Cancer Institute Alexis Vautrin of Vandoeuvre-les-Nancy.

For the study, researchers randomly badigned 548 women to mammograms allowing them to place their bads in machines and control their own compression, or to traditional mammograms with radiologists positioning women's bads.

The goal of bad compression is to make it as thin as possible to give radiologists a more detailed two-dimensional image, facilitating the detection of abnormalities that may be cancer.

Two things can go wrong when the bad is not sufficiently compressed in the mammography machine. Healthy tissues overlap to give the impression of potentially cancerous abnormalities and women undergo unnecessary invasive follow-up tests, or a true tumor is hidden behind healthy tissue and is not detected.

In the present study, however, when women squeezed their own bads into the machine, they reached bad thickness less than 3 millimeters from what they usually had with traditional mammography. This difference is too small to suggest that self-compression is not as effective as traditional mammograms, the study's authors conclude in JAMA Internal Medicine.

In fact, the researchers found that women were compressing their bads a little more, on average, than radiologists when they controlled the machines. But women also reported less pain when they handled the compression themselves.

"Although they know the usefulness of mammograms, many women dread this exam because it can be uncomfortable or painful," Henrot said by e-mail. "Self-compression could be offered as an alternative in women who fear to have a mammogram."

Neither was there any difference between the groups as to the image quality of the mammograms or the number of additional images that the radiologists had to take.

One of the limitations of the study was that many participants had a personal or family history of bad cancer, which could make their experience different from that of other women, note the authors of the study.

Nor did the study estimate the additional time it took to provide a mammogram when technicians explained to women how to manage compression themselves. Researchers point out that time constraints can have an impact on the number of places that can give women this option.

Although further research is still needed to show that self-compression is achievable, the results suggest that self-compression might be a way to make the mammography experience more tolerable, a said Dr. Deborah Korenstein of the Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College. At New York.

"The advantage of letting women do it themselves is twofold: the main concept is that it will result in a less painful test, which will prevent women from avoiding future mammograms for fear of discomfort," Korenstein said. , who did not participate in the process. study, said by email.

"It is also possible for women to tolerate more compression if they can control it themselves, which would result in better quality images," added Korenstein. "This has not been proven, but it is certainly a possibility."

Although some women may be less reluctant to have a mammogram when the experience is more comfortable, it's impossible to know if self-compression could make a significant difference in the proportion of women who undergo screening. by mammography, said Dr. Karsten Juhl Jorgensen, of Cochrane Nordic Center, Rigshospitalet, Copenhagen, Denmark.

And discomfort due to mammograms may not be the biggest problem with bad cancer screening, said Jorgensen, who did not participate in the study, by e-mail.

"There is a lot more damage to be taken into account than pain, for example the possibility of being diagnosed unnecessarily with cancer, a risk several times greater than the possibility of reducing bad cancer mortality", said Jorgensen.

SOURCE: bit.ly/2BnFrXR JAMA Internal Medicine, online February 4, 2019.